Coinsurance is the percentage of an eligible healthcare cost that a member is responsible for paying under their insurance plan. It applies after the relevant deductible has been met, although plan rules vary. A plan might, for example, pay 60% of its allowed amount while the member is responsible for the remaining 40%.
For out-of-network therapy, the calculation may use the insurer’s allowed amount rather than the therapist’s full fee. That means the client’s final cost can be affected by the allowed amount, deductible status, out-of-network benefits, and any plan-specific limits. Confirm the details with the insurer rather than estimating reimbursement from the session fee alone.